Skip to main content
SpringerLink
Log in

Comparative analysis of clinical outcomes for laparoscopic distal pancreatic resection and open distal pancreatic resection at a single institution

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Despite recent advances in laparoscopic pancreatic surgery, few studies have compared laparoscopic distal pancreatic resection (LDPR) with open distal pancreatic resection (ODPR). This study aimed to compare clinical outcomes for LDPR and ODPR performed at a single institution.

Methods

For this study, 93 patients with benign pancreatic disease underwent LDPR, and 35 patients with benign pancreatic disease underwent ODPR. Patient demographic characteristics, operative times, perioperative complications, length of hospital stay, and return to normal diet were compared retrospectively between the two groups.

Results

The LDPR and ODPR groups had the same demographic characteristics. The median operative time was 195 min in the LDPR group and 190 min in the ODPR group (p > 0.05). The rate of spleen preservation was higher in the LDPR group (40.8%) than in the ODPR group (5.7%) (p < 0.05) No operative mortality occurred in either group. The overall complication rate was 24.7% in the LDPR group and 29% in the ODPR group (p > 0.05). The rate of pancreas-related complications was 11.8% in the LDPR group and 17.2% in the ODPR group (p > 0.05). Pancreatic fistula developed in 8.6% of the LDPR group and in 14.3% of the ODPR group (p > 0.05). Bowel movement return to normal and resumption of normal diet were achieved 2.8 ± 1.3 days after the operation in the LDPR group and 4.5 ± 1.6 days after the operation in the ODPR group (p < 0.05). The median duration of hospital stay was 10 days for the LDPR group, which was significantly shorter than the 16 days for the ODPR group (p < 0.01).

Conclusion

The use of LDPR for benign lesions of the distal pancreas is feasible and safe. The LDPR procedure is associated with operative times and complication rates similar to those for ODPR, but LDPR has the advantages of an earlier return to normal bowel movements and normal diet and shorter hospital stays than ODPR.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Baca I, Klempa I, Gotzen V (1994) Laparoscopic pancreatocystojejunostomy without entero-entero-anastomosis. Chirurg 65:378–381

    PubMed  CAS  Google Scholar 

  2. Brune IB, Schonleben K (1992) Laparoscopic side-to-side gastrojejunostomy. Chirurg 63:577–580

    PubMed  CAS  Google Scholar 

  3. Cuschieri SA, Jakimowicz JJ, Stultiens G (1998) Laparoscopic infracolic approach for complications of acute pancreatitis. Semin Laparosc Surg 5:189–194

    PubMed  CAS  Google Scholar 

  4. Fletcher DR, Jones RM (1992) Laparoscopic cholecystjejunostomy as palliation for obstructive jaundice in inoperable carcinoma of pancreas. Surg Endosc 6:147–149

    Article  PubMed  CAS  Google Scholar 

  5. Shimi S, Banting S, Cuschieri A (1992) Laparoscopy in the management of pancreatic cancer: endoscopic cholecystojejunostomy for advanced disease. Br J Surg 79:317–319

    Article  PubMed  CAS  Google Scholar 

  6. Warshaw AL, Tepper JE, Shipley WU (1986) Laparoscopy in the staging and planning of therapy for pancreatic cancer. Am J Surg 151:76–80

    Article  CAS  Google Scholar 

  7. Pierce RA, Spitler JA, Hawkins WG, Strasberg SM, Linehan DC, Halpin VJ, Eagon JC, Brunt LM, Frisella MM, Matthews BD (2007) Outcomes analysis of laparoscopic resection of pancreatic neoplasms. Surg Endosc 21:579–586

    Article  PubMed  CAS  Google Scholar 

  8. Tang CN, Tsui KK, Ha JPY, Wong DCT, Li MKW (2007) Laparoscopic distal pancreatectomy: a comparative study. Hepatogastroenterol 54:265–271

    CAS  Google Scholar 

  9. Teh SH, Tseng D, Sheppard BC (2007) Laparoscopic and open distal pancreatic resection for benign pancreatic disease. J Gastrointest Surg 11:1120–1125

    Article  PubMed  Google Scholar 

  10. Velanovich V (2006) Case-control comparison of laparoscopic versus open distal pancreatectomy. J Gastrointest Surg 10:95–98

    Article  PubMed  Google Scholar 

  11. Sarr MG, Pancreatic Surgery Group (2003) The potent somatostatin analogue vapreotide does not decrease pancreas-specific complications after elective pancreatectomy: a prospective, multicenter, double-blinded, randomized, placebo-controlled trial. J Am Coll Surg 196:556–564

    Article  PubMed  Google Scholar 

  12. Velanovich V (2007) The use of tissue sealant to prevent fistula formation after laparoscopic distal pancreatectomy. Surg Endosc 21:1222–1225

    Article  PubMed  CAS  Google Scholar 

  13. Velanovich V (2006) The lasso technique for laparoscopic distal pancreatectomy. Surg Endosc 20:1766–1771

    Article  PubMed  CAS  Google Scholar 

  14. Warshaw AL (1988) Conservation of the spleen with distal pancreatectomy. Arch Surg 123:550–553

    PubMed  CAS  Google Scholar 

  15. Gagner M, Pomp A, Herrera MF (1996) Early experience with laparoscopic resections of islet cell tumors. Surgery 120:1051–1054

    Article  PubMed  CAS  Google Scholar 

  16. Melotti G, Butturini G, Piccoli M, Casetti L, Bassi C, Mullineris B, Lazzaretti MG, Pederzoli P (2007) Laparoscopic distal pancreatectomy: results on a consecutive series of 58 patients. Ann Surg 246:77–82

    Article  PubMed  Google Scholar 

  17. Assalia A, Gagner M (2004) Laparoscopic pancreatic surgery for islet cell tumors of the pancreas. World J Surg 28:1239–1247

    Article  PubMed  Google Scholar 

  18. Dulucq JL, Wintringer P, Stabilini C, Feryn T, Perissat J, Mahajna A (2005) Are major laparoscopic pancreatic resections worthwhile? A prospective study of 32 patients in a single institution. Surg Endosc 19:1028–1034

    Article  PubMed  CAS  Google Scholar 

  19. Edwin B, Mala T, Mathisen O, Gladhaug I, Buanes T, Lunde OC, Soreide O, Bergan A, Fosse E (2004) Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome. Surg Endosc 18:407–411

    Article  PubMed  CAS  Google Scholar 

  20. Lo CY, Chan WF, Lo CM, Fan ST, Tam PK (2004) Surgical treatment of pancreatic insulinomas in the era of laparoscopy. Surg Endosc 18:297–302

    Article  PubMed  Google Scholar 

  21. Mabrut JY, Fernandez-Cruz L, Azagra JS, Bassi C, Delvaux G, Weerts J, Fabre JM, Boulez J, Baulieux J, Peix JL, Gigot JF (2005) Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery 137:597–605

    Article  PubMed  Google Scholar 

  22. Palanivelu C, Shetty R, Jani K, Sendhilkumar K, Rajan PS, Maheshkumar GS (2007) Laparoscopic distal pancreatectomy: results of a prospective non-randomized study from a tertiary center. Surg Endosc 21:373–377

    Article  PubMed  CAS  Google Scholar 

  23. Park AE, Heniford BT (2002) Therapeutic laparoscopy of the pancreas. Ann Surg 236:149–158

    Article  PubMed  Google Scholar 

  24. Shimizu S, Tanaka M, Konomi H, Mizumoto K, Yamaguchi K (2004) Laparoscopic pancreatic surgery: current indications and surgical results. Surg Endosc 18:402–406

    Article  PubMed  CAS  Google Scholar 

  25. Stoker ME, Vose J, O’Mara P, Maini BS (1992) Laparoscopic cholecystectomy: a clinical and financial analysis of 280 operations. Arch Surg 127:1018–1024

    Google Scholar 

  26. Sussman LA, Christie R, Whittle DE, Sussman LA, Christie R, Whittle DE (1996) Laparoscopic excision of distal pancreas including insulinoma. ANZ J Surg 66:414–416

    Article  CAS  Google Scholar 

  27. Han HS, Min SK, Lee HK, Kim SW, Park YH (2005) Laparoscopic distal pancreatectomy with preservation of the spleen and splenic vessels for benign pancreas neoplasm. Surg Endosc 19:1367–1369

    Article  PubMed  Google Scholar 

  28. Patterson EJ, Gagner M, Salky B, Inabet WB, Brower S, Edye M, Gurland B, Reiner M, Pertsemlides D (2001) Laparoscopic pancreatic resection: single-institution experience of 19 patients. J Am Coll Surg 193:281–287

    Article  PubMed  CAS  Google Scholar 

  29. Barlehner E, Anders S, Schwetling R (2002) Laparoscopic resection of the left pancreas: technique and indication. Dig Surg 19:507–510

    Article  PubMed  CAS  Google Scholar 

  30. Lillemoe KD, Kaushal S, Cameron JL, Sohn TA, Pitt HA, Yeo CJ (1999) Distal pancreatectomy: indications and outcomes in 235 patients. Ann Surg 229:693–698

    Article  PubMed  CAS  Google Scholar 

  31. Corcione F, Marzano E, Cuccurullo D, Caracino V, Pirozzi F, Settembre A (2006) Distal pancreas surgery: outcome for 19 cases managed with a laparoscopic approach. Surg Endosc 20:1729–1732

    Article  PubMed  CAS  Google Scholar 

  32. Cuschieri A, Jakimowicz JJ, Van Spreeuwel J (1996) Laparoscopic distal 70% pancreatectomy and splenectomy for chronic pancreatitis. Ann Surg 223:280–285

    Article  PubMed  CAS  Google Scholar 

  33. Fabre JM, Dulucq JL, Vacher C, Lemoine MC, Wintringer P, Nocca D, Burgel JS, Domergue J (2002) Is laparoscopic left pancreatic resection justified? Surg Endosc 16:1358–1361

    Article  PubMed  CAS  Google Scholar 

  34. Santoro E, Carlini M, Carboni F (1999) Laparoscopic pancreatic surgery: indications, techniques, and preliminary results. Hepatogastroenterology 46:1174–1180

    PubMed  CAS  Google Scholar 

  35. Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M (2005) Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138:8–13

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Ulsan University College of Medicine and Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea

    Song C. Kim, Kwan T. Park, Ji W. Hwang, Hyeng C. Shin & Duck J. Han

  2. Department of Gastroenterology, Ulsan University College of Medicine and Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea

    Sang S. Lee, Dong W. Seo, Sung K. Lee & Myung H. Kim

Authors
  1. Song C. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kwan T. Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ji W. Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hyeng C. Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sang S. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dong W. Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sung K. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Myung H. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Duck J. Han
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Song C. Kim.

Additional information

To be presented at the 2008 Society of American Gastroinestinal Endoscopic Surgeons (SAGES) Meeting.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, S.C., Park, K.T., Hwang, J.W. et al. Comparative analysis of clinical outcomes for laparoscopic distal pancreatic resection and open distal pancreatic resection at a single institution. Surg Endosc 22, 2261–2268 (2008). https://doi.org/10.1007/s00464-008-9973-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-008-9973-1

Keywords

Search

Navigation